82 - Thrombocytopenia and retinopathy of prematurity

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 82
Publication Number: 82.43

Mohamed Mansour, Cleveland Clinic Children's, Parma Heights, OH, United States; Hany Aly, Cleveland Clinic Children's, Cleveland, OH, United States; Mohamed A. Mohamed, Cleveland Clinic Children's, Cleveland, OH, United States

Presenting Author(s)

Mohamed Mansour, MD

Fellow
Cleveland Clinic Children's
Parma Heights, Ohio, United States

Background: There is a unique relationship between platelets and Retinopathy of prematurity (ROP) in preterm infants. Exposure to supplemental oxygen, hypercapnia, and inflammation are among the predisposing factors. It is not known if thrombocytopenia is associated with ROP.

Objective:

To assess the association of thrombocytopenia with the development of ROP in very low birth weight (VLBW) infant.

Design/Methods: We included all VLBW infants < 1500g born at our hospital network from January 2019- December 2021. We divided sample into two groups: Group A included infants with thrombocytopenia (platelet count < 150,000) and Group B included infants without thrombocytopenia. We used chi square test to calculate frequencies and odds ratios (OR) of the association of thrombocytopenia with ROP of any grade and severe ROP (grades 3 or 4). We calculated adjusted OR (aOR) using logistic regression model to control for confounding factors associated with ROP including gestational age (GA), birth weight (BW), sex, small for gestational age (SGA) status, respiratory distress syndrome (RDS) requiring surfactant instillation, bronchopulmonary dysplasia (BPD) as a surrogate for continued need for supplemental oxygen up to 36 weeks postnatal age, or significant adverse events occurred during hospitalization such as early or late sepsis, necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH) or periventricular leukomalacia (PVL). We also examined the correlation between platelets count as a continuous variable and degree of ROP using correlation coefficient analysis.

Results:

Sample included 407 VLBW infants. Of them, 51% were females, 48% were Caucasians, 25% were SGA, 71% born via Cesarean deliveries. Mean GA was 28.2 weeks and mean BW was 1012g. Median Apgar score at 5 minutes is 7. Thirty percent of the infants had any grade ROP and 9% had severe ROP. Thrombocytopenia occurred in 42% of the infants, platelet count < 50,000 occurred in 17%, and 16% of the infants received platelets transfusion. ROP of any grade occurred in 47% of infants in group A compared to 16% in group B, aOR 2.8 (95%CI: 1.2-6.6, p=0.02). Severe ROP occurred in 20% of infants in group A while none of the infants in group B developed severe ROP. The lower the platelets count, the higher the grade of ROP, with Spearman Correlation Coefficient (-0.36, p < 0.001).

Conclusion(s):

Thrombocytopenia is independently associated with ROP in VLBW infants. The grade of ROP is inversely correlated with the platelets count. Further studies are needed to identify what is causing ROP; low platelets vs transfusion of platelets.